I’m working on night float this week for the Heme-Onc service. This means that I take all admissions coming in, and manage the floor patients. The one perk of this job is not having to write progress notes in the morning. The flip side is that you have to deal with otherwise stable patients who go berserk at night. Aside from my pager going nuts occasionally, the hospital itself is relatively quiet.

medical resident work area

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medicine coca-cola, medicine, work

Congratulations to all the matched ophthalmology applicants! You are one step closer to your career choice.  It doesn’t appear that anyone from my medical school class will be at my program, but I’m assuming they’ve done quite well. What do the applicants usually do the evening before match day? I can tell you what I did around this time of year in the distant past…

I was out in San Francisco, just finishing up a preliminary year interview. I hung out with the ‘ole bunch of computing programming venture capitalists playing RockBand (it had just been released) until the wee hours of the morning. It was good to see a vision of what I could have been doing had I continued the programming lifestyle instead of going to medical school (posh apartment, Motrin gumball machine at the office, money, odd hours.. ). After I found out that I had matched, I went out to the wharf where the SFMatch offices were at…somewhere out on Beach St. It’s near the Ghirardelli complex. Great fun… Where were you at?

SF Match Ophthalmology headquarters

medicine ophthalmology

Several months ago when I was on the surgical oncology team, we ran the patient list in the surgical conference room on the 4th floor every day.  There’s  a shiny plaque on the door that looks like this:

4th floor conference room door

I later found out this guy on the door is Mehmet Oz‘s dad, who was also a CT surgeon.  Jeez, this guy and his family is everywhere. Mehmet Oz is one of the CT surgeons who’s an attending at my med school. He’s everywhere–on Oprah, on XM Satellite radio’s Oprah channel, on Discovery Health Channel, in books, magazines, you name it.  I remember that he gave us a lecture about homeopathic living once. “Put your olive oil in the fridge, drink [nasty-tasting-previously-thought-to-be-nonedible-substance] every morning…etc”.  I remember him talking about giving the patient headphones with Mozart playing in the background because it helps speed recovery.  Yeah. I’d give the guy headphones too, because we surely don’t want the patient to overhear us jamming out to AC/DC tunes intermixed with occasional swearing by the surgeons in the OR.

Anyway, this guy is a smart man, and a great marketer.  Also a weird coincidence that I’d end up in the small town where this famous guy grew up.  I feel privileged.

medicine life, medicine

It’s absurd how much you can specialize within ophthalmology itself: anterior segment (refractive vs. transplantation), neuro-ophthalmology, glaucoma, retina (medical, surgical, or both), oculo-plastics, pediatrics. Buddy, you’ve only got like 23mm of eyeball to work with. What’s worse is that people asked me what I want to specialize in during my residency interviews. “Looks like you received a recommendation from a retinal surgeon… is that what you want to do?” Why can’t I just be a general ophthalmologist? I drew a cartoon reflecting my views on the matter.

sub-specialization in ophthalmology

medicine ophthalmology, toon

Some 30 million people in the US suffer from chronic sinusitis; a handful more are blessed with an acute episode around this time of year. If you’ve had a nose full of snot at some point in your life, then you know what I’m talking about.  I’ve been having a bad cold that’s been kicking my butt over the last few weeks, and I’ve been rinsing my nostrils with two interesting devices that have been helpful in relieving my symptoms.

Left: sinus rinse bottle; Right: Neti Pot;

These two rinses are made by the same company, and you can find them at the pharmacy department at most department stores. Each one holds about 8oz of water.  The company that manufacturers the bottles also sells “sinus rinse” packets that you mix into the water. These packets contain a mix of salt and baking soda in some “secret proportion”. I’ve found that 1/2 tsp of sea salt (or any non-iodinized salt) plus a pinch of baking soda works just nicely in 8oz warm water.

nasal rinse; external pressure causes the solution to rise up the tube and through the spout

The sinus rinse bottle is a positive pressure system that forces the rinse through your nostrils as you squeeze the bottle.  The Neti pot (shaped like a watering pot) flows into your nostrils passively with gravity as you tilt the spout into your nose.  Both are meant to flush the mucus buildup that forms when you’re sick.

I think both of the devices work well in relieving congestion.  The rinse bottle delivers extra pressure through your nose, which is helpful in moving along the more persistent of the mucus. It also may also cause more discomfort–it takes some time to get used to having water flowing through your nose. The end result is a happier,  less congested nose.  Nasal rinsing is a relatively harmless means to clean out your stuffy nose, and you can use it several times a day.

* Note. The above statements reflect my personal opinion about the topic. While I am a physician, you should discuss with your situation with your doctor before attempting any new medical regimen.

medicine congestion, neti pot, saline rinse, sinus rinse, sinusitis, stuffy nose